Sharma Parul, Solanki Nitin, Vegada Bhavisha
Department of Community Medicine, GMERS Medical College, Dharpur, Patan, Gujarat, India.
Department of Community Medicine, GMERS Medical College, Valsad, Gujarat, India.
Indian J Community Med. 2024 Nov-Dec;49(6):843-848. doi: 10.4103/ijcm.ijcm_19_23. Epub 2024 Oct 17.
Public health action (PHA) in tuberculosis (TB) includes six components: doing screening for HIV/diabetes, carrying out drug susceptibility testing, counseling on tobacco, counseling on nutrition, benefits of Nikshay Poshan Yojana, and contact tracing. All the patients notified by the private practitioners (PPs) and missing any of the above components are intervened by the government staff to cover all the above components.
The aim of the article is (1) to assess the timeliness and completeness of PHA and (2) to assess the impact of PHA on the quality of care for TB patients in the private sector.
A sequential mixed-method (cross-sectional study followed by qualitative study) study was carried out in the Patan district, North Gujarat for a period of one year. Quantitative data were collected through home visits to patients residing in three randomly selected talukas out of nine talukas in the Patan district. Qualitative data were collected purposively from selected clinics of PPs (including a mix of PP notifying and not notifying TB till saturation is achieved) from the above talukas.
Out of a total of 176 patients from the private sector, 48 patients took all six components of PHA. Out of them, 98% were cured compared to 82% who did not receive PHA. None of the PP had heard about PHA or its components.
The Public-private model for TB management needs strengthening. Regular and mandatory training of PPs on the latest TB management guidelines including importance of timely and complete PHA should be carried out.
结核病公共卫生行动（PHA）包括六个组成部分：开展艾滋病毒/糖尿病筛查、进行药敏试验、提供烟草咨询、提供营养咨询、介绍尼凯什亚·波山·约贾纳的福利以及接触者追踪。所有由私人执业医生（PPs）报告但缺少上述任何一个组成部分的患者，政府工作人员都会进行干预，以涵盖所有上述组成部分。
本文的目的是（1）评估PHA的及时性和完整性，以及（2）评估PHA对私营部门结核病患者护理质量的影响。
在古吉拉特邦北部的帕坦地区进行了一项为期一年的序贯混合方法（横断面研究后进行定性研究）。通过对帕坦地区九个乡中随机选择的三个乡的患者进行家访收集定量数据。定性数据是从上述乡中选定的私人执业医生诊所（包括通知和未通知结核病直至达到饱和的私人执业医生混合样本）中有意收集的。
在来自私营部门的总共176名患者中，48名患者接受了PHA的所有六个组成部分。其中接受所有六个组成部分的患者中，98%治愈，而未接受PHA的患者治愈率为82%。没有一个私人执业医生听说过PHA或其组成部分。
结核病管理的公私合作模式需要加强。应定期对私人执业医生进行关于最新结核病管理指南的强制性培训，包括及时和完整的PHA的重要性。
